Department of Microbiology, P D Hinduja Hospital, Mumbai, 400016, India.
Apollo Cancer Institute, 320 Anna Salai, Chennai 600035, India.
Indian J Med Microbiol. 2022 Jul-Sep;40(3):374-377. doi: 10.1016/j.ijmmb.2022.05.010. Epub 2022 Jun 9.
Faecal carriage of carbapenemase-producing Enterobacterales (CPE) has been extensively investigated in hospitalized patients, but limited data is available on the carriage rate in healthy individuals in India.
A total of 1000 stool samples were screened for CPE from healthy individuals in Chennai (n = 50), Hyderabad (n = 184) and Mumbai (n = 766). Diluted stool samples were cultured on chromID CARBA SMART plates. Growing colonies were screened for CPE by RAPIDEC® CARBA NP Test and minimum inhibitory concentration (MIC) of imipenem by E-Test. PCR was performed for confirmation of CPE genes.
Out of the 1000 stool samples tested, 6.1% were positive for CPE. A total of 64 carbapenem resistant isolates (56 E.coli, 4 Klebsiella pneumoniae, 3 Enterobacter cloacae and 1 Citrobacter freundii) were recovered from ChromID CARBA SMART biplate. Carbapenemase production was identified in 57/64 isolates by RAPIDEC® CARBA NP test. PCR analysis showed 28 bla and 33 bla. Three remaining isolates (2 E.coli, 1 K.pneumoniae) were negative for the tested carbapenemase genes. Interestingly, out of these 61 PCR positive isolates, 49.1% displayed imipenem MIC within the susceptibility range on the basis of CLSI interpretative criteria.
Faecal carriage of CPE among healthy individuals was 6.1%. Comprehensive measures to improve the sanitation scenario and implementation of National AMR action plan are needed to prevent further generation and dissemination of carbapenem resistant Enterobacterales (CRE).
产碳青霉烯酶肠杆菌科（CPE）的粪便携带情况在住院患者中已得到广泛研究，但在印度健康人群中的携带率数据有限。
从钦奈（n=50）、海德拉巴（n=184）和孟买（n=766）的健康个体中筛选了 1000 份粪便样本以检测 CPE。稀释的粪便样本在 chromID CARBA SMART 平板上进行培养。通过 RAPIDEC® CARBA NP 测试和 E-Test 检测亚胺培南的最小抑菌浓度（MIC）筛选出产 CPE 的生长菌落。通过 PCR 检测 CPE 基因。
在检测的 1000 份粪便样本中，有 6.1%为 CPE 阳性。从 ChromID CARBA SMART 双平板中回收了 64 株耐碳青霉烯的分离株（56 株大肠埃希菌、4 株肺炎克雷伯菌、3 株阴沟肠杆菌和 1 株弗氏柠檬酸杆菌）。RAPIDEC® CARBA NP 试验鉴定了 57/64 株分离株产碳青霉烯酶。PCR 分析显示，28 株 bla 和 33 株 bla。其余 3 株（2 株大肠埃希菌，1 株肺炎克雷伯菌）对检测的碳青霉烯酶基因均呈阴性。有趣的是，在这 61 株 PCR 阳性的分离株中，根据 CLSI 解释标准，49.1%的分离株对亚胺培南的 MIC 处于敏感性范围内。
健康人群中 CPE 的粪便携带率为 6.1%。需要采取综合措施改善卫生状况，并实施国家 AMR 行动计划，以防止碳青霉烯耐药肠杆菌科（CRE）的进一步产生和传播。
